Billing code 20900: Bone graft harvestMedicare rate & RVUs
Reports harvesting a small autogenous bone graft from a donor site for use in a reconstructive or orthopedic procedure requiring bone grafting.
Medicare pays $398.14 for 20900 nationally in the office and $160.66 in a hospital or facility. Local office rates run $350.28–$527.10.
Medicare rate · 20900
Bone graft harvest
Swap in your local Medicare rate.
- Work RVUs
- 2.93
- Total RVUs
- 11.92
- Global days
- 000
National rate · 2026
$398.14
Office setting, before claim adjustments.
See every locality for 20900 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 20900 covers
This service covers obtaining a small piece of the patient’s own bone for grafting, such as a small dowel- or button-shaped piece. An orthopedic, spine, or reconstructive surgeon may harvest it during an operation in which another site needs bone graft material. The operative record should identify the donor site and describe the harvested graft and the procedure for which it is used.
Select this code when the harvested graft is minor or small; code 20902 represents a major or large harvest. Report the harvest with the procedure that uses the graft when separately supported by the operative work. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 20900 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$350.28 to $527.10
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $355.65 | $147.86 |
| Alaska* | $458.35 | $205.43 |
| Arizona | $387.02 | $156.90 |
| Arkansas | $350.28 | $146.29 |
| Atlanta | $406.20 | $164.92 |
| Austin | $412.99 | $161.74 |
| Bakersfield | $421.02 | $160.74 |
| Baltimore/Surr. Cntys | $424.25 | $169.44 |
| Beaumont | $371.42 | $155.31 |
| Brazoria | $392.84 | $157.49 |
| Chicago | $421.01 | $182.34 |
| Chico | $419.65 | $159.37 |
| Colorado | $413.99 | $161.31 |
| Connecticut | $425.35 | $169.58 |
| Dallas | $395.61 | $159.08 |
| Dc + Md/Va Suburbs | $455.83 | $176.08 |
| Delaware | $393.60 | $158.97 |
| Detroit | $399.19 | $170.02 |
| East St. Louis | $391.66 | $173.17 |
| El Centro | $419.73 | $159.45 |
| Fort Lauderdale | $414.79 | $174.22 |
| Fort Worth | $392.97 | $158.82 |
| Fresno | $419.65 | $159.37 |
| Galveston | $394.17 | $158.36 |
| Hanford-Corcoran | $419.65 | $159.37 |
| Hawaii, Guam | $430.33 | $160.31 |
| Houston | $402.96 | $167.14 |
| Idaho | $366.95 | $148.47 |
| Indiana | $369.15 | $149.00 |
| Iowa | $364.31 | $147.02 |
| Kansas | $362.90 | $148.22 |
| Kentucky | $365.23 | $154.11 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $448.78 | $167.84 |
| Madera | $419.65 | $159.37 |
| Manhattan | $459.84 | $183.89 |
| Merced | $419.65 | $159.37 |
| Metropolitan Boston | $455.53 | $171.98 |
| Metropolitan Kansas City | $380.43 | $157.44 |
| Metropolitan Philadelphia | $414.65 | $167.43 |
| Metropolitan St. Louis | $384.53 | $158.45 |
| Miami | $434.31 | $187.09 |
| Minnesota | $395.09 | $150.73 |
| Mississippi | $354.44 | $149.97 |
| Modesto | $419.65 | $159.37 |
| Montana** | $398.11 | $160.63 |
| Napa | $486.81 | $173.81 |
| Nebraska | $366.28 | $147.09 |
| Nevada** | $395.75 | $158.03 |
| New Hampshire | $407.79 | $160.57 |
| New Mexico | $377.77 | $160.00 |
| New Orleans | $383.55 | $160.08 |
| North Carolina | $373.31 | $151.74 |
| North Dakota** | $388.62 | $151.14 |
| Northern Nj | $450.87 | $175.40 |
| Nyc Suburbs/Long Island | $471.86 | $189.50 |
| Ohio | $373.54 | $156.72 |
| Oklahoma | $364.15 | $152.08 |
| Oxnard-Thousand Oaks-Ventura | $446.57 | $165.86 |
| Portland | $427.15 | $163.31 |
| Poughkpsie/N Nyc Suburbs | $432.91 | $172.87 |
| Puerto Rico | $401.02 | $160.93 |
| Queens | $463.22 | $182.52 |
| Redding | $419.65 | $159.37 |
| Rest Of California | $419.65 | $159.37 |
| Rest Of Florida | $393.70 | $166.67 |
| Rest Of Georgia | $370.52 | $158.69 |
| Rest Of Illinois | $382.44 | $165.62 |
| Rest Of Louisiana | $364.78 | $154.61 |
| Rest Of Maine | $369.34 | $150.86 |
| Rest Of Maryland | $401.21 | $160.88 |
| Rest Of Massachusetts | $411.51 | $161.45 |
| Rest Of Michigan | $375.48 | $158.66 |
| Rest Of Missouri | $358.50 | $153.79 |
| Rest Of New Jersey | $429.76 | $170.43 |
| Rest Of New York | $379.17 | $153.56 |
| Rest Of Oregon | $392.24 | $155.71 |
| Rest Of Pennsylvania | $373.95 | $155.94 |
| Rest Of Texas | $382.09 | $156.72 |
| Rest Of Washington | $410.64 | $160.58 |
| Rhode Island | $407.65 | $162.33 |
| Riverside-San Bernardino-Ontario | $424.83 | $164.55 |
| Sacramento-Roseville-Folsom | $440.55 | $164.36 |
| Salinas | $438.93 | $163.69 |
| San Diego-Chula Vista-Carlsbad | $449.44 | $165.42 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $515.30 | $180.45 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $514.76 | $179.91 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $527.10 | $184.65 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $524.87 | $182.42 |
| San Luis Obispo-Paso Robles | $431.87 | $161.38 |
| Santa Cruz-Watsonville | $453.87 | $165.33 |
| Santa Maria-Santa Barbara | $440.62 | $163.72 |
| Santa Rosa-Petaluma | $458.44 | $166.82 |
| Seattle (King Cnty) | $464.62 | $173.23 |
| South Carolina | $374.13 | $154.70 |
| South Dakota** | $387.49 | $150.01 |
| Southern Maine | $389.66 | $154.32 |
| Stockton | $419.65 | $159.37 |
| Suburban Chicago | $418.88 | $174.98 |
| Tennessee | $364.85 | $148.98 |
| Utah | $379.45 | $156.22 |
| Vallejo | $486.02 | $173.02 |
| Vermont | $387.38 | $152.27 |
| Virgin Islands | $401.02 | $160.93 |
| Virginia | $388.59 | $155.15 |
| Visalia | $419.65 | $159.37 |
| West Virginia | $367.81 | $161.44 |
| Wisconsin | $375.11 | $147.60 |
| Wyoming** | $393.97 | $156.49 |
| Yuba City | $419.65 | $159.37 |
20900 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$350.28
$473.38
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $458.35 | 1 |
| AL | $355.65 | 1 |
| AR | $350.28 | 1 |
| AZ | $387.02 | 1 |
| CA | $419.65–$527.10 | 29 |
| CO | $413.99 | 1 |
| CT | $425.35 | 1 |
| DC | $455.83 | 1 |
| DE | $393.60 | 1 |
| FL | $393.70–$434.31 | 3 |
| GA | $370.52–$406.20 | 2 |
| GU | $430.33 | 1 |
| HI | $430.33 | 1 |
| IA | $364.31 | 1 |
| ID | $366.95 | 1 |
| IL | $382.44–$421.01 | 4 |
| IN | $369.15 | 1 |
| KS | $362.90 | 1 |
| KY | $365.23 | 1 |
| LA | $364.78–$383.55 | 2 |
| MA | $411.51–$455.53 | 2 |
| MD | $401.21–$455.83 | 3 |
| ME | $369.34–$389.66 | 2 |
| MI | $375.48–$399.19 | 2 |
| MN | $395.09 | 1 |
| MO | $358.50–$384.53 | 3 |
| MS | $354.44 | 1 |
| MT | $398.11 | 1 |
| NC | $373.31 | 1 |
| ND | $388.62 | 1 |
| NE | $366.28 | 1 |
| NH | $407.79 | 1 |
| NJ | $429.76–$450.87 | 2 |
| NM | $377.77 | 1 |
| NV | $395.75 | 1 |
| NY | $379.17–$471.86 | 5 |
| OH | $373.54 | 1 |
| OK | $364.15 | 1 |
| OR | $392.24–$427.15 | 2 |
| PA | $373.95–$414.65 | 2 |
| PR | $401.02 | 1 |
| RI | $407.65 | 1 |
| SC | $374.13 | 1 |
| SD | $387.49 | 1 |
| TN | $364.85 | 1 |
| TX | $371.42–$412.99 | 8 |
| UT | $379.45 | 1 |
| VA | $388.59–$455.83 | 2 |
| VI | $401.02 | 1 |
| VT | $387.38 | 1 |
| WA | $410.64–$464.62 | 2 |
| WI | $375.11 | 1 |
| WV | $367.81 | 1 |
| WY | $393.97 | 1 |
How the 20900 rate is calculated
Each of 20900’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 20900
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.93Practice expense 8.51Malpractice 0.48
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 20900
The CMS indicators that decide how 20900 is paid alongside other services.
CMS payment indicators · 20900
Bone graft harvest
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
20900 without 51 · national office
$398.14
Bone graft harvest
20900-51 · Second procedure: 50%
$199.07
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
20900 compared with similar codes
Compare codes
20900 vs 20902 vs 20936 vs 20937 vs 20938: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 20902Bone graft harvest
- Both represent harvesting the patient’s bone for a graft. Choose 20900 for a minor or small harvest and 20902 for a major or large harvest.
- 20936Sp bone agrft local add-on
- 20936 describes local spinal autograft obtained through the operative incision. Use 20900 for a separately documented small bone harvest rather than local bone collected at the recipient site.
- 20937Spinal bone graft
- 20937 represents a separately harvested morselized autograft for spinal surgery. Choose 20900 for a minor or small harvest that is not being reported under that spinal graft code.
- 20938Spinal bone graft
- 20938 represents a separately harvested structural autograft for spinal surgery. It differs from 20900, which identifies a minor or small bone harvest.
20900 billing questions
How is 20900 distinguished from 20902?
Use 20900 for a minor or small bone harvest and 20902 for a major or large harvest. The operative documentation should support the extent of the harvest.
Is 20900 an add-on code?
No add-on status is listed for 20900. Report it for the separately performed small bone harvest when the operative record supports that work.
Can 20900 be reported with a spinal graft code?
A small separate-site harvest is distinct from local spinal autograft represented by 20936. Codes 20937 and 20938 describe other spinal autograft approaches, so select based on the documented graft and harvest method.
Should modifier 50 be appended for bilateral harvesting?
No. Modifier 50 is inappropriate for 20900 under the CMS bilateral adjustment rule.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure. When other procedures are performed in the same session, standard multiple-procedure payment reduction applies.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 20900 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →